三种不同时相螺旋CT检查对壶腹周围癌的术前价值分析目的对三种MSCT扫描方案是否适合于术前评估进行比较研究,从而确定最佳增强扫描方案。
方法本课题研究对象为38例壶腹周围癌,均行三种不同时相螺旋CT检查。
将结果分为三组进行对比分析,第1组(动脉期和门脉期),第2组(胰腺实质期和门脉期),第3组(动脉期、胰腺实质期和门脉期)。
对壶腹周围癌于三种不同时相影像诊断与手术病理或ERCP活检结果进行比较,评估肿瘤是否可以手术切除,并与手术结果对照。
结果三组扫描方式对壶腹周围癌术前可切除性评价的阳性预测值、阴性预测值、特异度及准确率分别为:第1组:88.5%、66.7%、80%、81.6%,第2组:100%、80%、100%及94.7%,第3组:100%、88.9%、100%及97.4%。
第1组诊断结果与第3组间有统计学差异。
结论多层螺旋CT三期扫描应作为壶腹周围癌术前评估的最佳扫描方案,联合应用低张法能显著提高壶腹周围癌的诊断符合率,并为术式选择提供重要依据。
【Abstract】Objective On the three combined in terms of predictability for studied surgical resectability assessment of Periampulla Carcinoma.The final choice best enhanced scanning options.Methods 38 patients suspected of having Periampulla Carcinoma were divided into 3 groups,and MDCT scans were performed with different scanning techniques for these groups:group 1,with arterial phase and portal venous phase;group 2,with pancreatic parenchyma phase and portal venous phase;group 3,with arterial phase,pancreatic parenchyma phase and portal venous phase.For patients with Periampulla Carcinoma were included in the imaging analyses and and histopathologic results.The tumor resectability was also evaluated and eventually correlated with surgical results.Results The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of these three groups were as follows respectively:88.5%、66.7%、80%、81.6% for group 1; 100%、80%、100%、94.7%for group 2;and 100%、88.9%、100%、97.4%for group 3.Conclusion Three phases scan should be as Periampullary Cancer surgery the best scanning program,combined with low tension can significantly improve Periampullary Ca diagnosis and to provide important basis for the selection of surgery.【Key words】Periampulla Carcinoma;Multi slice Helical CT(MSCT);SurgeryMSCT问世以来,扫描速度得到很大的提高,使得胰腺三期增强扫描成为可能,从而壶腹周围癌的CT检出率越来越高。
